摘要
目的:探讨影响原发性肝细胞性肝癌(hepatocellular carcinoma,HCC)术后复发的因素,为术中术后治疗及判断预后提供依证据。方法:回顾分析1998年1月～2005年6月,我院94例HCC术后复发病例的临床和病理资料,将病人分为近期复发(≤2年)和远期复发(>2年)两组,分析比较两组患者的性别、年龄、初诊症状、HBsAg、肝功能Child分级、AFP值、肝硬化、肿瘤病灶、肿瘤大小、肿瘤包膜、血管侵犯和转移、手术切缘、病理分级、术后综合治疗、再次手术和术中出血量等在近远期复发有无差异。结果:肝癌术后2年内和2年后复发在肿瘤大小、肿瘤包膜、血管侵犯和转移、手术切缘、术中出血量、术后综合治疗以及再次手术的差异有统计学意义,是复发的危险因素;而在性别、年龄、初诊症状、HBsAg,肝硬化、肝功能Child分级、AFP值、肿瘤病灶和病理分级上的差异无统计学意义。结论:影响HCC肝切除术后近期和远期复发的临床和病理因素可能不同,早期发现肝癌,规范的手术切除,减少手术出血量,术后复发采取综合治疗是改善患者预后的重要措施。
Objective： To explore the influencing factors of the recurrence for hepatocellular carcinoma（ HCC） after surgery and provide evidence for treatment and judgement prognosis during operation and post - operation. Methods： A retrospective survey about chnical pathological data was carried out in 94 recurrent patients with HCC underwent hepatectomy between Jan 1998 and Jun 2005. All the patients were divided into two follow - up groups, like early（ 〈 2 years） and late （ 〉 2 years） recurrence groups and statistical analysis was done to evaluate the influence of sex, age, preliminary diagnosis symptom, HBsAg, Child grade, AFP, hver cirrhosis, tumor lesion, tumor size, tumor capsule, invasion, metastasis, resection margin, pathological grade, combined therapy, reoperation and bleeding volume during operation. Results：The recurrent patients within and after 2 years showed statistical differences on tumor size, tumor capsule,invasion, metastasis, resection margin, bleeding volume during operation, combined therapy and reoperation, the remained factors have not seen differences significantly. Conclusion： Chnical pathological factors of the short - term and long - term recurrence may be different, early diagnosis, standard hepatectomy, less bleeding loss and comprehensive treatment after operation may be crucial to improve prognosis.
出处
《激光杂志》
CAS
CSCD
北大核心
2007年第2期91-92,共2页
Laser Journal
关键词
原发性肝细胞性肝癌
复发
肝切除术
primary hepatacellular carcinoma
recurrence
hepatcctomy
